|
1
|
Zamparini F, Spinelli A, Lenzi J, Peters OA, Gandolfi MG, Prati C. Retreatment or replacement of previous endodontically treated premolars with recurrent apical periodontitis? An 8-year historical cohort study. Clin Oral Investig 2025; 29:181. [PMID: 40074937 PMCID: PMC11903559 DOI: 10.1007/s00784-025-06238-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2024] [Accepted: 02/16/2025] [Indexed: 03/14/2025]
Abstract
OBJECTIVES The study evaluated previously-endodontically-treated premolars affected by periapical lesions and/or secondary caries requiring a multidisciplinary decision between (non-surgical) retreatment or extraction and implant replacement over an 8-year minimum follow-up. MATERIALS AND METHODS The decision-making was performed among a pool of patients attending a University Dental School. All patients presented at least one failing previously endodontically treated premolar. Recorded parameters were: structural conditions (residual coronal-structure, caries), periodontal and endodontic status (CEJ-MBL, initial-PAI, post-presence). Two experienced operators made the decision-making and classified teeth as retreatable and restorable (Endo-group) or suitable for extraction and implant replacement (Implant-group). Logistic regression and Cox-proportional-hazard analyses with clustered-standard-errors compared baseline-characteristics and treatment-outcomes. Odds-ratios (ORs) with 95% confidence-intervals (CIs) were reported for baseline-characteristics. Hazard-ratios (HRs) expressed the association of treatment-groups with time-to-event. RESULTS Ninety-six patients (n = 124 premolars) were enrolled (49 M;47 F; mean-age 53.1 ± 11.6 years). The decision-making splitted 54.8% treatments to Endo-group (n = 68) and 45.2% to Implant-group (n = 56). The 8-year survival were 85.1% for Endo-group and 98.2% for Implant-group. The 8-year success were 80.5% and 93.9%. The HR from Cox regression favored Implant-group (HR = 0.12, P = 0.049). The Endo-group showed the highest number of critical complications (15%) due to fractures, despite the healing of lesions. Implant-group had a higher percentage of minor prosthetic complications (14%). CONCLUSIONS Endo-group demonstrated higher percentage of critical complications compared to Implant-group during the follow-up. Root fractures were accounted as main responsible, while periapical disease did not affect healing, survival and clinical longevity. CLINICAL SIGNIFICANCE Insufficient crown structure was the major parameter associated with root fracture. In these cases, implant replacement strategy represented an adequate therapy justified by the higher success compared to root canal retreatment.
Collapse
Affiliation(s)
- Fausto Zamparini
- Endodontic Clinical Section, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
- Laboratory of Green Biomaterials and Oral Pathology, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Andrea Spinelli
- Endodontic Clinical Section, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Ove A Peters
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
| | - Maria Giovanna Gandolfi
- Laboratory of Green Biomaterials and Oral Pathology, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Carlo Prati
- Endodontic Clinical Section, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| |
Collapse
|
|
2
|
Gala R, Al Sammarraie M, Padilla RS, Zhou Z, Neely AL, Kinaia BM. Digitally guided root removal and simultaneous implant placement: A case study. Clin Adv Periodontics 2025; 15:69-76. [PMID: 38708920 DOI: 10.1002/cap.10292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Encountering a retained root tip post-extraction and prior to implant placement is a possible clinical complication. There are numerous approaches for removing retained roots that may be traumatic or atraumatic. Regardless of the approach, careful treatment planning is important to minimize complications, reduce morbidity, and preserve bony structures. The aim of the current case study is to introduce a technique and digitally generated device used for identifying and atraumatically removing a retained root tip and simultaneously placing a stable dental implant. METHODS A 63-year-old female with a history of myocardial infarction, hypertension, and acute pancreatitis presented for implant placement at site #5. Clinical examination revealed adequate interocclusal, mesiodistal, and buccolingual dimensions for implant placement. Radiographic examination using cone beam computed tomography revealed that retained root #5 interfered with implant placement. Digital planning was used to extract the root tip with minimal trauma to maintain adequate bone for simultaneous implant placement with good primary stability. RESULTS The follow-ups at 1, 3, and 6 weeks and 4, 8, and 10 months revealed good bone preservation with an osseointegrated implant. CONCLUSIONS Employment of digital planning to create a palatal window allowed excellent accuracy in removing the retained root while maintaining the bony foundation for a well osseointegrated dental implant. KEY POINTS Pre-planning using cone beam computed tomography scan merged with an intraoral digital scan is necessary for precise location of a retained root and correct implant placement with excellent primary stability. A digitally planned 3D surgical guide is a useful method for extracting retained roots during implant placement to minimize bone damage. Digital planning provides a precise and minimally invasive implant surgery.
Collapse
Affiliation(s)
- Roksolana Gala
- Division of Graduate Studies, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
| | - Mohammed Al Sammarraie
- Division of Graduate Studies, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
| | - Rocio Sanchez Padilla
- Division of Graduate Studies, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
| | - Zheng Zhou
- Division of Graduate Studies, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
- Private Practice, Sterling Heights, Michigan, USA
| | - Anthony L Neely
- Division of Graduate Studies, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
- Private Practice, Southfield, Michigan, USA
| | - Bassam M Kinaia
- Division of Graduate Studies, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
- Private Practice, Sterling Heights, Michigan, USA
| |
Collapse
|
|
3
|
Sirinirund B, Zalucha J, Rodriguez Betancourt AB, Kripfgans OD, Wang C, Velasquez D, Chan H. Clinical outcomes of using operating microscope for alveolar ridge preservation: A randomized controlled trial. J Periodontol 2025; 96:230-240. [PMID: 39403776 PMCID: PMC11951953 DOI: 10.1002/jper.24-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 07/01/2024] [Accepted: 07/15/2024] [Indexed: 03/29/2025]
Abstract
BACKGROUND The use of the operating microscope (OM) for extraction and alveolar ridge augmentation (ARP) is increasing due to enhanced magnification and illumination. The primary objective was to compare the wound healing and crestal bone quality after the use of OM and dental loupes (DL) for ARP. METHODS Forty non-molar teeth with periapical lesions in need of extraction and ARP from 33 patients were randomly assigned to 2 groups: DL (control) or OM (test). All procedures were performed by 1 surgeon and assessments done by masked examiners. ARP was performed with an allograft and a resorbable collagen membrane. The presence of granulomatous tissue remnants after debridement was recorded. Cone-beam computed tomography (CBCT) and ultrasound (US) scans were taken during the healing phase up to 16-week visits. Bone cores were retrieved from implant osteotomies for histologic analysis. Patient-reported outcome measurements (PROMs) were assessed. RESULTS All patients completed all study visits except 1 who dropped out before the last visit. After socket debridement, the test group exhibited significantly fewer sites with tissue remnants (p = 0.01) and a better healing score at 2-week (p = 0.04) and 4-week (p = 0.01) time points. There were no significant differences in 12-week crestal bone healing by histology (p = 0.1), US (p = 0.85), and CBCT healing (p = 0.64) at 12 weeks, as well as PROMs (p > 0.1). CONCLUSION Within the limitation of the study, the use of OM for ARP resulted in significantly fewer tissue remnants and favorable early visual wound healing. CBCT and US-derived-crestal bone quality did not show a difference between the 2 groups. PLAIN LANGUAGE SUMMARY Alveolar ridge preservation (ARP) by placing bone particulates in the extraction socket, covered by a wound dressing material, is commonly applied immediately after tooth extraction to reduce jawbone shrinkage in preparation for implant placement later. The jawbone healing varies, depending largely on the ability to remove the etiology, socket features, extent of surgical trauma, and wound stability. Healed jawbone with good quality is favorable for easiness of implant placement and could be related to maintenance of long-term implant health. The surgical microscope with high magnification (up to ∼25×) and co-axial illumination is ideal for assistance in the removal of granulomatous tissue that is believed to interfere with healing, performance of minimally invasive extraction, and stabilization of the wound with meticulous tissue management and fine sutures. This study compared the use of the surgical microscope to dental loupes for ARP in a randomized controlled design. The microscope-assisted ARP is associated with a significantly higher chance of removing granulomatous tissue, favorable early healing, and similar crestal bone quality. Removal of granulomatous tissue is significant for immediate implant placement. This study serves as a model for testing the benefits of the surgical microscope for encouraging early healing in more challenging intraoral surgical procedures.
Collapse
Affiliation(s)
- Benyapha Sirinirund
- Department of Restorative Dentistry and PeriodontologyFaculty of DentistryChiang Mai UniversityChiang MaiThailand
| | - Janet Zalucha
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | | | - Oliver D. Kripfgans
- Department of Biomedical EngineeringUniversity of MichiganAnn ArborMichiganUSA
- Department of RadiologyUniversity of Michigan School of MedicineAnn ArborMichiganUSA
| | - Chin‐Wei Wang
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
- Division of Periodontics, Department of DentistryTaipei Medical University HospitalTaipeiTaiwan
- Graduate Institute of Clinical DentistryNational Taiwan UniversityTaipeiTaiwan
- School of DentistryCollege of Oral MedicineTaipei Medical UniversityTaipeiTaiwan
| | - Diego Velasquez
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
- Private PracticeFentonMichiganUSA
| | - Hsun‐Liang Chan
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
- Division of PeriodontologyCollege of DentistryThe Ohio State UniversityColumbusOhioUSA
| |
Collapse
|
|
4
|
Gao Y, Ma J. Prevention of retrograde peri-implantitis caused by pulpal/periapical lesions in adjacent teeth: A literature review. J Dent 2024; 151:105434. [PMID: 39481828 DOI: 10.1016/j.jdent.2024.105434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Accepted: 10/23/2024] [Indexed: 11/03/2024] Open
Abstract
OBJECTIVES To present a comprehensive review on retrograde peri-implantitis (RPI), focusing on its epidemiology, etiology, clinical manifestations, classification, treatment, and prevention strategies. DATA The widespread development of implantology has led to heightened concerns regarding implant failure attributed to peri-implantitis (PI). In contrast to conventional PI, retrograde peri-implantitis (RPI), defined as inflammation originating from the apical of the implant towards the crown, has gained increasing attention. Various factors can contribute to RPI, among which untreated pulpal/periapical lesions from adjacent teeth are considered as main causes. SOURCES AND STUDY SELECTION Using PubMed as the source for eligible literature, a total of 73 cases (from 36 articles) were identified for review. The search items are: ("retrograde peri-implantitis" OR "periapical peri-implantitis" OR "peri-apical implant lesion*") AND ("risk factor*" OR "treatment*" OR "prevent*"). CONCLUSIONS Currently, clinicians often inadequately address the evaluation and management of pulpal/periapical lesions in the adjacent teeth in RPI, neglecting its causes and further the preventive measures. Overall, RPI influences the success of dental implants and therefore valid diagnosis and prevention are obligatory. Until now, there has been no relative instructions for clinicians. Moreover, new research directions (e.g. molecular biology and immunology) as well as innovative treatment (e.g. lasers and novel materials) may facilitate the precise prevention and early diagnosis of RPI.
Collapse
Affiliation(s)
- Yushan Gao
- School of Stomatology, Capital Medical University, Beijing 100050, China
| | - Jinling Ma
- Department of Multi-Disciplinary Treatment Center, School of Stomatology, Capital Medical University, Beijing 100050, China.
| |
Collapse
|
|
5
|
Do JH, Cobb CM. Perigraftitis and implant therapy: A case report. Clin Adv Periodontics 2024; 14:172-179. [PMID: 37986692 DOI: 10.1002/cap.10271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/14/2023] [Accepted: 10/21/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND A previous case study reported periimplantitis and concomitant perigraftitis of a second implant placed at a site that had alveolar ridge preservation three decades earlier. Infection at the site persisted 4 months after implant removal by flapless implant reversal. A flap was subsequently reflected, the grafted bone was removed, and a second alveolar ridge preservation was performed with a freeze-dried bone allograft. The publication reported infection resolved, and the site healed uneventfully. However, it is unknown if placement of another implant at the site would be successful. The purpose of this paper is to report on the findings at surgical reentry and outcome of the third implant. METHODS Eleven months after the second alveolar ridge preservation, the site was reentered. The bone graft was found to be partially soft tissue encapsulated. All encapsulated graft materials and soft tissue were removed. An implant was placed, and the alveolar defect was grafted with a demineralized bone allograft. Seventeen months after implant placement, a buccal free gingival graft was performed during which the crestal bone adjacent to the implant was found to be hard and corticated. The implant was deemed to be osseointegrated and restored after soft tissue healing. RESULTS Twenty-five months after implant placement, the third implant remained functional and asymptomatic with the peri-implant bone exhibiting normal trabeculation. CONCLUSIONS Implant therapy can be successful following treatment and resolution of perigraftitis. KEY POINTS Perigraftitis may play a contributing role in the biologic complications of implants that have been placed into grafted bone. Perigraftitis may be successfully resolved by completely removing all grafted bone. Once perigraftitis has been eliminated, an implant may be successfully placed.
Collapse
Affiliation(s)
- Jonathan H Do
- Section of Periodontics, UCLA School of Dentistry, Los Angeles, California, USA
- Private Practice, Poway, California, USA
| | - Charles M Cobb
- Department of Periodontics, School of Dentistry, University of Missouri-Kansas City, Kansas City, Missouri, USA
| |
Collapse
|
|
6
|
Oh SL, Tordik PA. Treatment of Retrograde Peri-Implantitis Originating From Apical Periodontitis of an Adjacent Tooth: A Clinical Case Letter. J ORAL IMPLANTOL 2024; 50:402-407. [PMID: 38822658 DOI: 10.1563/aaid-joi-d-24-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
This report aims to present a treatment of retrograde peri-implantitis originating from apical periodontitis of an adjacent tooth in an 84-year-old male. Apical periodontitis of the maxillary left central incisor (#9) extended to the apex of the maxillary left lateral incisor implant (#10), which had been functioning for 16 years. Root canal treatment for #9 was performed, followed by root end surgery to treat the apical periodontitis, which showed a periapical radiolucency measured 1 cm in its greatest dimension. After the root end filling was placed, neither bone substitute materials nor barrier membranes were used to fill and cover the bony defect area. A 2-year postoperative radiograph confirmed the osseous healing around the apices of #9 and #10.
Collapse
Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Patricia A Tordik
- University of Maryland School of Dentistry, Baltimore, Maryland, USA
| |
Collapse
|
|
7
|
Park WB, Okany KP, Park W, Han JY, Lim HC, Kang P. Atypical and Late-Developed Sinus Graft Complications Following Maxillary Sinus Augmentation: Successful Management with Guided Bone Regeneration. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1246. [PMID: 39202527 PMCID: PMC11355990 DOI: 10.3390/medicina60081246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/16/2024] [Accepted: 07/23/2024] [Indexed: 09/03/2024]
Abstract
Complications that occur after maxillary sinus floor augmentation (MSA) can be divided into early and late complications. Early complication is a side effect that occurs during the MSA procedure or during the initial healing period. Usually, late complication refers to a side effect that occurs after 3 weeks of MSA. However, in the longer term, there are cases that occur during the follow-up period after the prosthesis is delivered, and most of them present with peri-implantitis. In the present two cases, sinus graft complications occurred 1-2 years after prosthesis delivery but were independent of peri-implantitis and had atypical features showing asymptomatic results. Although the route of the infection source is unclear, the lesions were presumed to be caused by slow and delayed inflammation of oral bacteria infiltrating the bone graft area of the maxillary sinus. Within the limitations of present case reports, bone defects were successfully managed with a guided bone regeneration (GBR) procedure that included thorough defect degranulation, surface decontamination of exposed implant, and regrafting. Periodic monitoring of radiographic images is required for the detection of unusual sinus graft complications in sinus-augmented sites.
Collapse
Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University; Seoul 02447, Republic of Korea;
- Private Practice in Periodontics and Implant Dentistry, Seoul 02771, Republic of Korea
| | - Kenechi P. Okany
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences Columbia University College of Dental Medicine, #PH7E-110, 630 W. 168 St., New York, NY 10032, USA;
| | - Wonhee Park
- Department of Dentistry, Division of Dentistry, College of Medicine, Hanyang University, Gyeongchun-ro, Guri-si 11923, Republic of Korea;
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, College of Medicine, Hanyang University, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea;
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyunghee Daero 23, Dongdaemoon-gu, Seoul 02447, Republic of Korea
| | - Philip Kang
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences Columbia University College of Dental Medicine, #PH7E-110, 630 W. 168 St., New York, NY 10032, USA;
| |
Collapse
|
|
8
|
Atieh MA, Alsabeeha NHM. Peri-implantitis Through the Looking Glass. Int Dent J 2024; 74:42-45. [PMID: 37891059 PMCID: PMC10829342 DOI: 10.1016/j.identj.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/18/2023] [Accepted: 09/05/2023] [Indexed: 10/29/2023] Open
Affiliation(s)
- Momen A Atieh
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates; Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
| | - Nabeel H M Alsabeeha
- Department of Dental Services, Emirates Health Services, Dubai, United Arab Emirates
| |
Collapse
|
|
9
|
Sgarbanti C, Mauro FA. Treatment and Resolution of an Implant Periapical Lesion (IPL) with Guided Bone Regeneration. Case Rep Dent 2023; 2023:6624249. [PMID: 37869521 PMCID: PMC10586895 DOI: 10.1155/2023/6624249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/07/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Background Implant periapical lesion (IPL) is a rare condition that can affect dental implants. Several different approaches have been proposed for the treatment of this condition. Awareness and literature discussing this condition and possible treatment options have grown significantly in the last 25 years. Case Presentation. The present case report describes the treatment of an implant periapical lesion with a combined approach consisting of surgical lesion removal, mechanical instrumentation with titanium brush, detoxification with tetracycline, and guided bone regeneration (GBR) with demineralized allograft bone and cross-linked collagen membrane. The patient was followed up for 6 months postoperatively, showing complete resolution of the buccal fistula. No signs or symptoms of discomfort or pathology were reported. Conclusions The case report presented a combined approach that can be successful in the surgical treatment of an IPL in which the implant stability is maintained.
Collapse
Affiliation(s)
- Carlo Sgarbanti
- Department of Dental Diagnostic and Surgical Sciences, Dr Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | |
Collapse
|
|
10
|
Park WB, Villa M, Han JY, Lim HC, Kang P. Lateral Peri-Implantitis: Successful Management via Guided Bone Regeneration at Mandibular First Molar Implant. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1691. [PMID: 37763809 PMCID: PMC10534790 DOI: 10.3390/medicina59091691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
Infections occurring around implants are divided into marginal peri-implantitis and retrograde peri-implantitis (RPI). Marginal peri-implantitis starts in the crestal bone and progresses to the apical portion, and RPI starts in the apical bone and progresses to the coronal portion. However, lateral peri-implantitis (LPI) occurring on the side of the implant body has not yet been reported, and the cause is unclear. This 63-year-old male patient is a case of unusual bone resorption that occurred in the lateral portion of the implant body 26 months after lateral bone augmentation. The origin of LPI was an infection at the site of laterally augmented bone. Rather than implant removal, this report demonstrates an alternative treatment option of guided bone regeneration after the enucleation and detoxification of the implant surface with successful clinical and radiographic results for 2 years.
Collapse
Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul 02447, Republic of Korea;
- Private Practice in Periodontics and Implant Dentistry, Seoul 02771, Republic of Korea
| | - Michael Villa
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY 10032, USA;
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, College of Medicine, Hanyang University, 222-1 Wangsimni-ro, Seongdong, Seoul 04763, Republic of Korea;
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyunghee daero 23, Dongdaemoon, Seoul 02447, Republic of Korea
| | - Philip Kang
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY 10032, USA;
| |
Collapse
|
|
11
|
Yang H, Luo D, Yuan MJ, Yang JJ, Wang DS. Five-year outcomes of immediate implant placement for mandibular molars with and without chronic apical periodontitis: A retrospective study. World J Clin Cases 2023; 11:5218-5229. [DOI: 10.12998/wjcc.v11.i22.5218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Most physicians consider molars with chronic apical periodontitis (CAP) lesions as contraindications for immediate implant placement. At the patient’s request, we perform immediate implant placement of the mandibular molars with CAP in clinical practice.
AIM To retrospectively analyze and compare the 5-year outcomes of immediate implant placement of the mandibular molars with CAP and those without obvious inflammation.
METHODS The clinical data of patients with immediate implant placement of the mandibular molars in the Department of Oral and Maxillofacial Surgery, the Affiliated Hospital of Qingdao University, from June 2015 to June 2017 were collected. The patients were divided into CAP (n = 52) and no-CAP (n = 45) groups. Changes in bone mineral density and bone mass around implants were analyzed 5 years after implant restoration.
RESULTS At 5 years after implantation, the peri-implant bone mineral density was 528.2 ± 78.8 Hounsfield unit (HU) in the CAP group and 562.6 ± 82.9 HU in the no-CAP group (P = 0.126). Marginal bone resorption around implants did not differ significantly between the two groups, including buccal (P = 0.268) or lingual (P = 0.526) resorption in the vertical direction or buccal (P = 0.428) or lingual (P = 0.560) resorption in the horizontal direction. Changes in the peri-implant jump space did not differ significantly between the two groups, including the buccal (P = 0.247) or lingual (P = 0.604) space in the vertical direction or buccal (P = 0.527) or lingual (P = 0.707) space in the horizontal direction. The gray value of cone-beam computed tomography measured using Image J software can reflect the bone mineral density. In the CAP area, the gray values of the bone tissue immediately and 5 years after implant placement differed significantly from those of the surrounding bone tissue (P < 0.01).
CONCLUSION The results of this study suggest that immediate implant placement of the mandibular molars with CAP can achieve satisfactory 5-year clinical results, without significant differences in the complications, survival rate, or bone tissue condition from the no-CAP mandibular molars.
Collapse
Affiliation(s)
- Hua Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Dan Luo
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Mu-Jie Yuan
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Jian-Jun Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Da-Shan Wang
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| |
Collapse
|
|
12
|
Yang H, Luo D, Yuan MJ, Yang JJ, Wang DS. Five-year outcomes of immediate implant placement for mandibular molars with and without chronic apical periodontitis: A retrospective study. World J Clin Cases 2023; 11:5224-5235. [PMID: 37621586 PMCID: PMC10445073 DOI: 10.12998/wjcc.v11.i22.5224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Most physicians consider molars with chronic apical periodontitis (CAP) lesions as contraindications for immediate implant placement. At the patient's request, we perform immediate implant placement of the mandibular molars with CAP in clinical practice. AIM To retrospectively analyze and compare the 5-year outcomes of immediate implant placement of the mandibular molars with CAP and those without obvious inflammation. METHODS The clinical data of patients with immediate implant placement of the mandibular molars in the Department of Oral and Maxillofacial Surgery, the Affiliated Hospital of Qingdao University, from June 2015 to June 2017 were collected. The patients were divided into CAP (n = 52) and no-CAP (n = 45) groups. Changes in bone mineral density and bone mass around implants were analyzed 5 years after implant restoration. RESULTS At 5 years after implantation, the peri-implant bone mineral density was 528.2 ± 78.8 Hounsfield unit (HU) in the CAP group and 562.6 ± 82.9 HU in the no-CAP group (P = 0.126). Marginal bone resorption around implants did not differ significantly between the two groups, including buccal (P = 0.268) or lingual (P = 0.526) resorption in the vertical direction or buccal (P = 0.428) or lingual (P = 0.560) resorption in the horizontal direction. Changes in the peri-implant jump space did not differ significantly between the two groups, including the buccal (P = 0.247) or lingual (P = 0.604) space in the vertical direction or buccal (P = 0.527) or lingual (P = 0.707) space in the horizontal direction. The gray value of cone-beam computed tomography measured using Image J software can reflect the bone mineral density. In the CAP area, the gray values of the bone tissue immediately and 5 years after implant placement differed significantly from those of the surrounding bone tissue (P < 0.01). CONCLUSION The results of this study suggest that immediate implant placement of the mandibular molars with CAP can achieve satisfactory 5-year clinical results, without significant differences in the complications, survival rate, or bone tissue condition from the no-CAP mandibular molars.
Collapse
Affiliation(s)
- Hua Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Dan Luo
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Mu-Jie Yuan
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Jian-Jun Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Da-Shan Wang
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| |
Collapse
|
|
13
|
Algahtani FN, Hebbal M, Alqarni MM, Alaamer R, Alqahtani A, Almohareb RA, Barakat R, Abdlhafeez MM. Prevalence of bone loss surrounding dental implants as detected in cone beam computed tomography: a cross-sectional study. PeerJ 2023; 11:e15770. [PMID: 37551351 PMCID: PMC10404392 DOI: 10.7717/peerj.15770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/28/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVES The objective of this study was to assess the prevalence of crestal, and apical bone loss (CBL & ABL) associated with dental implants in CBCT scans. The second objective was to assess the radiographic stage of implant disease and the visible predisposing factors. MATERIALS AND METHODS The CBCT scans that were taken from January 2015 to January 2022 in King Saud Medical City were screened to examine the marginal and periapical condition of dental implants. Information related to demographic variables, stage of bone loss, and radiographically evident predisposing factors were collected. The results were analyzed using descriptive statistics, chi-square test, and logistic regression analysis. RESULTS In total, 772 implant scans were analyzed. The prevalence of crestal bone loss and apical bone loss around the implants were 6.9% and 0.4% respectively. The amount of bone loss was moderate in 52.8% of cases of CBL and 100% mild in cases of ABL. The risk factors for CBL were patient age (p < 0.001), implant location (p < 0.001), bone loss in proximal teeth (p < 0.001), and adjacent edentulous sites (p < 0.001). The risk factors for ABL were adjacent periapical infection (p < 0.001) and endodontic therapy (p = 0.024). CONCLUSION The prevalence of CBL and ABL was low. The CBCT can be used as a diagnostic tool for studying the prevalence of bone loss associated with peri-implant disease and relevant risk factors. The implantation of CBCT to evaluate the success and the prognosis of dental implants or the treatment of peri-implant diseases can be further considered in future research.
Collapse
Affiliation(s)
- Fahda N. Algahtani
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mamata Hebbal
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Rahaf Alaamer
- College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Anwar Alqahtani
- College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Rahaf A. Almohareb
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Reem Barakat
- Dental Clinics Department, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Manal M. Abdlhafeez
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Qassim, Saudi Arabia
- Department of Endodontics, Faculty of Dentistry, October University for Modern Sciences and Arts, 6th of October City, Egypt
| |
Collapse
|
|
14
|
Wang Y, Cao X, Shen Y, Zhong Q, Huang Y, Zhang Y, Wang S, Xu C. Initial Development of an Immediate Implantation Model in Rats and Assessing the Prognostic Impact of Periodontitis on Immediate Implantation. Bioengineering (Basel) 2023; 10:896. [PMID: 37627781 PMCID: PMC10451242 DOI: 10.3390/bioengineering10080896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND To establish an immediate implantation rat model and to evaluate the effects of pre-existing periodontitis and two different socket rinse solutions on immediate implantation prognosis. METHODS Sprague-Dawley (SD) rats were randomly divided into three groups before immediate implantation, including the control group, the group with experimentally induced periodontitis (EP), in which rats have been experimentally induced periodontitis before implantation, and the group with induced periodontitis and with extraction sockets rinsed with three percent H2O2 (EP-H2O2), in which rats have been induced periodontitis before implantation, and extraction sockets were rinsed with three percent H2O2. Periodontitis was induced by ligating the thread around the molars for four weeks. Six weeks after titanium alloy implants were self-tapped and left to heal transmucosally, maxillae were dissected after the clinical examination to perform micro-CT and histological analysis. RESULTS An immediate implantation model was successfully built in rats. There was no significant difference in implant survival rates between the EP and control groups. However, the clinical examination results, micro-CT analysis, and histological analysis in EP and EP-H2O2 groups showed a significantly worse prognosis than in the control group. Three percent H2O2 showed a similar effect with saline. CONCLUSION This study presented a protocol for establishing a rat immediate implantation model and showed that periodontitis history might negatively affect the prognosis of immediate implantation. These findings urge caution and alternative strategies for patients with periodontal disease history, enhancing the long-term success of immediate implantation in dental practice. Additionally, the comparable outcomes between 3% H2O2 and saline suggest the use of saline as a cost-effective and safer alternative for implant site preparation in dental practice.
Collapse
Affiliation(s)
- Yingying Wang
- Department of Prosthodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, No. 639 Zhizaoju Road, Shanghai 200011, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, No. 639 Zhizaoju Road, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Ximeng Cao
- Department of Prosthodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, No. 639 Zhizaoju Road, Shanghai 200011, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, No. 639 Zhizaoju Road, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Yingyi Shen
- Department of Prosthodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, No. 639 Zhizaoju Road, Shanghai 200011, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, No. 639 Zhizaoju Road, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Qi Zhong
- Department of Prosthodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, No. 639 Zhizaoju Road, Shanghai 200011, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, No. 639 Zhizaoju Road, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Yujie Huang
- Department of Prosthodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, No. 639 Zhizaoju Road, Shanghai 200011, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, No. 639 Zhizaoju Road, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Yifan Zhang
- Department of Prosthodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, No. 639 Zhizaoju Road, Shanghai 200011, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, No. 639 Zhizaoju Road, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Shaohai Wang
- Department of Stomatology, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Road, Shanghai 200120, China
| | - Chun Xu
- Department of Prosthodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, No. 639 Zhizaoju Road, Shanghai 200011, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, No. 639 Zhizaoju Road, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China
| |
Collapse
|
|
15
|
Alssum LR, Alghofaily MM, Aleyiydi AS, Alomar SA, Alsalleeh FM. The Incidence of Retrograde Peri-Implantitis in a Single University Dental Hospital Training Center: A Retrospective Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:560. [PMID: 36984561 PMCID: PMC10051226 DOI: 10.3390/medicina59030560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/15/2023]
Abstract
Background and objective: Retrograde peri-implantitis (RPI) is a periapical radiolucent lesion developed around the implant apex. This study aimed to investigate the Incidence of RPI in a single university dental hospital training center. Materials and Methods: All records of patients who received single Implants between 2016-2020 were screened. For cases that met inclusion criteria, clinical and radiographic data were analyzed. Results: A total of 215 were included and categorized as follows, Category A: implants were placed next to endodontically treated teeth (n = 58, 27%); category B, implants placed at the sites with previous endodontic involvement within 6 months of tooth extraction (n = 25, 11.6%); Category AB: implants placed at sites that fulfill the criteria of groups A and B (n = 18, 8.4%); and Category C: Implants that were placed next to vital teeth and at a site with no previous endodontic treatment or a site that was allowed to heal for more than six (n = 114, 53%). Categories A, B and AB served as the endodontically involved (EI) group, while category C served as non- endodontically involved (NEI) group. Only two sites (0.9%) were confirmed as RPI, both from group A (3.4%). Comparing all groups studied showed no statistically significant difference in RPI incidence. Conclusions: The incidence of RPI is low; however, endodontically treated teeth with periapical lesions (PALs) next to an implant site could contribute to RPI.
Collapse
Affiliation(s)
- Lamees R. Alssum
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Maha M. Alghofaily
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Asrar S. Aleyiydi
- College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Sadeem A. Alomar
- College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Fahd M. Alsalleeh
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| |
Collapse
|
|
16
|
Gholami L, Shahabi S, Jazaeri M, Hadilou M, Fekrazad R. Clinical applications of antimicrobial photodynamic therapy in dentistry. Front Microbiol 2023; 13:1020995. [PMID: 36687594 PMCID: PMC9850114 DOI: 10.3389/fmicb.2022.1020995] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023] Open
Abstract
Given the emergence of resistant bacterial strains and novel microorganisms that globally threaten human life, moving toward new treatment modalities for microbial infections has become a priority more than ever. Antimicrobial photodynamic therapy (aPDT) has been introduced as a promising and non-invasive local and adjuvant treatment in several oral infectious diseases. Its efficacy for elimination of bacterial, fungal, and viral infections and key pathogens such as Streptococcus mutans, Porphyromonas gingivalis, Candida albicans, and Enterococcus faecalis have been investigated by many invitro and clinical studies. Researchers have also investigated methods of increasing the efficacy of such treatment modalities by amazing developments in the production of natural, nano based, and targeted photosensitizers. As clinical studies have an important role in paving the way towards evidence-based applications in oral infection treatment by this method, the current review aimed to provide an overall view of potential clinical applications in this field and summarize the data of available randomized controlled clinical studies conducted on the applications of aPDT in dentistry and investigate its future horizons in the dental practice. Four databases including PubMed (Medline), Web of Science, Scopus and Embase were searched up to September 2022 to retrieve related clinical studies. There are several clinical studies reporting aPDT as an effective adjunctive treatment modality capable of reducing pathogenic bacterial loads in periodontal and peri-implant, and persistent endodontic infections. Clinical evidence also reveals a therapeutic potential for aPDT in prevention and reduction of cariogenic organisms and treatment of infections with fungal or viral origins, however, the number of randomized clinical studies in these groups are much less. Altogether, various photosensitizers have been used and it is still not possible to recommend specific irradiation parameters due to heterogenicity among studies. Reaching effective clinical protocols and parameters of this treatment is difficult and requires further high quality randomized controlled trials focusing on specific PS and irradiation parameters that have shown to have clinical efficacy and are able to reduce pathogenic bacterial loads with sufficient follow-up periods.
Collapse
Affiliation(s)
- Leila Gholami
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Shiva Shahabi
- Dental Implants Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marzieh Jazaeri
- Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahdi Hadilou
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran,*Correspondence: Reza Fekrazad,
| |
Collapse
|
|
17
|
Solomonov M, Via S, Dinur N, Itzhak JB, Lev R, Averbuch Zehavi E, Arbel Y, Lvovsky A, Azizi H, Abadi M, Cohen MN, Shemesh A. Retrograde peri-implantitis: incidence and possible co-existing factors. A retrospective analysis. Aust Dent J 2022; 67:340-343. [PMID: 35748525 DOI: 10.1111/adj.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the incidence of Retrograde peri-implantitis (RPI) generally and the incidence of RPI with an endodontic-treated adjacent tooth and/or a periapical radiolucency. METHODS The retrospective case-control study included the follow-up periapical images of single dental implants. Two calibrated graduate endodontic residents evaluated simultaneously the presence of RPI and the adjacent teeth status (a previous root canal treatment (RCT) and the periapical status). RESULTS Six hundred eleven dental implants were included in this study. Twenty-three implants with RPI were detected (the incidence of RPI was 3.7%). Thirty-one adjacent teeth to the implants with RPI were recognized. Out of them, seven teeth had a previous RCT and periapical radiolucency or no RCT and periapical radiolucency. The odds ratios for RPI in an implant with periapical radiolucency or with RCT at the adjacent tooth are 6.67 (95% CI 2.7-16.5), p<0.05; and 0.11 (95% CI 0.007 - 1.9), p>0.05 respectively. CONCLUSIONS Based on periapical radiographs, the RPI incidence was 3.7% in the present study. The incidence of RPI increased in cases with adjacent teeth that had periapical radiolucency. Previous RCT in teeth adjacent to implants without apical radiolucency is not correlated with RPI. © 2022 Australian Dental Association.
Collapse
Affiliation(s)
- Michael Solomonov
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel.,"Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shlomo Via
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Periodontology, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
| | - Noam Dinur
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel.,"Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel.,"Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ron Lev
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Periodontology, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
| | - Elor Averbuch Zehavi
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Periodontology, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
| | - Yael Arbel
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Periodontology, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
| | - Alex Lvovsky
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel.,"Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hadas Azizi
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel.,"Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Meital Abadi
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Prosthodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
| | - Matityahu Neriya Cohen
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Orthodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel
| | - Avi Shemesh
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel.,"Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
|
18
|
Implant Periapical Lesion: Clinical and Histological Analysis of Two Case Reports Carried Out with Two Different Approaches. Bioengineering (Basel) 2022; 9:bioengineering9040145. [PMID: 35447705 PMCID: PMC9030256 DOI: 10.3390/bioengineering9040145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 11/16/2022] Open
Abstract
Periapical implantitis (IPL) is an increasingly frequent complication of dental implants. The causes of this condition are not yet entirely clear, although a bacterial component is certainly part of the etiology. In this case series study, two approaches will be described: because of persistent IPL symptoms, a patient had the implant removed and underwent histological analysis after week 6 from implantation. The histomorphometric examination revealed a 35% bone-implant contact area involving the coronal two-thirds of the implant. The apical portion of the fixture on the other hand was affected by an inflammatory process detectable on radiography as a radiolucent area. The presence of a probable root fragment, detectable as an imprecise radiopaque mass in the zone where the implant was later placed, confirms the probable bacterial etiology of this case of IPL. On the other hand, in case number 2, the presence of IPL around the fixture was solved by surgically removing the implant apical third as well as the adjacent tooth apex. It may be concluded from our histological examination that removal of the apical portion of the fixture should be considered an effective treatment for IPL since the remaining implant segment remains optimally osseointegrated and capable of continuing its function as a prosthetic abutment. Careful attention, however, is required at the implantation planning stage to identify in advance any sources of infection in the edentulous area of interest which might compromise the final outcome.
Collapse
|
|
19
|
Implant Periapical Lesion: A Narrative Review. TECHNOLOGIES 2021. [DOI: 10.3390/technologies9030065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Implant periapical lesion (IPL) is an infectious-inflammatory alteration surrounding an implant apex. It is a multifactorial disease that may ultimately cause implant failure. The diagnosis of IPL is based on examination of clinical manifestations and apical radiolucency. Many etiologies have been attributed to IPL, including preexisting microbial pathology and surgical trauma. Moreover, many systems have been used to classify IPL based on different parameters. To date, non-surgical and surgical treatment, as well as removal of failed implants, have been considered to successfully manage IPL. However, prevention of IPL surpasses all modes of treatment. An increased number of IPL cases are expected as implants have become standard for tooth replacement in dentate arches. Therefore, it is necessary to understand IPL more comprehensively. Herein, an introduction to IPL, including its etiology, diagnosis, classification, treatment, and prevention, has been undertaken.
Collapse
|
|
20
|
Castellanos-Cosano L, Carrasco-García A, Corcuera-Flores JR, Silvestre-Rangil J, Torres-Lagares D, Machuca-Portillo G. An evaluation of peri-implant marginal bone loss according to implant type, surgical technique and prosthetic rehabilitation: a retrospective multicentre and cross-sectional cohort study. Odontology 2021; 109:649-660. [PMID: 33496913 DOI: 10.1007/s10266-020-00587-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/21/2020] [Indexed: 02/01/2023]
Abstract
To evaluate implant loss (IL) and marginal bone loss (MBL); follow-up period of up to 10 years after prosthetic loading. Retrospective multi-centre cross-sectional cohort study. Double analysis: (1) all the implants (n = 456) were analysed; (2) to allow for possible cluster error, one implant per patient (n = 143) was selected randomly. Statistical analysis: Spearman's correlation coefficient; Kruskal-Wallis (post-hoc U-Mann-Whitney); Chi-square (post-hoc Haberman). (1) Analysing all the implants (456): IL was observed in patients with past periodontitis (6 vs. 2.2%, p < 0.05), short implants (12 vs. 2.8%, p < 0.001) and when using regenerative surgery (11.3 vs. 2.9%, p < 0.001); greater MBL was observed among smokers (0.39 ± 0.52 vs. 0.2 ± 0.29, p < 0.01), maxillary implants (0.28 ± 0.37 vs. 0.1 ± 0.17, p < 0.0001), anterior region implants (0.32 ± 0.36 vs. 0.21 ± 0.33, p < 0.001), external connection implants (0.2 ± 0.29 vs. 0.63 ± 0.59, p < 0.0001), and 2-3 years after loading (p < 0.0001). (2) analysing the cluster (143): IL was observed in smokers (18.8 vs. 3.5%, p < 0.05), splinted fixed crowns (12.9%, p < 0.01), short implants (22.2 vs. 4.0%, p < 0.01) and when using regenerative surgery (19.2 vs. 3.4%, p < 0.01); greater MBL was observed in maxillary implants (0.25 ± 0.35 vs. 0.11 ± 0.18, p < 0.05), in the anterior region (p < 0.05), in the first 3 years (p < 0.01), in external connection implants (0.72 ± 0.71 vs. 0.19 ± 0.26, p < 0.01) and in short implants (0.38 ± 0.31 vs. 0.2 ± 0.32, p < 0.05). There is greater risk in smokers, patients with past periodontal disease, external connection implants, the use of short implants and when regenerative techniques are used. To prevent MBL and IL, implantologists should be very meticulous in indicating implants in patients affected by these host factors.
Collapse
Affiliation(s)
| | | | | | - Javier Silvestre-Rangil
- Department of Stomatology, Stomatology and Oral Surgery, Dr. Peset University Hospital, University of Valencia, Valencia, Spain
| | - Daniel Torres-Lagares
- Professor and Chairman of Special Care Dentistry, School of Dentistry, University of Seville, C/Avicena S/N, 41009, Seville, Spain
| | - Guillermo Machuca-Portillo
- Professor and Chairman of Special Care Dentistry, School of Dentistry, University of Seville, C/Avicena S/N, 41009, Seville, Spain.
| |
Collapse
|
|
21
|
Di Murro B, Canullo L, Pompa G, Di Murro C, Papi P. Prevalence and treatment of retrograde peri-implantitis: a retrospective cohort study covering a 20-year period. Clin Oral Investig 2021; 25:4553-4561. [PMID: 33443685 PMCID: PMC8310488 DOI: 10.1007/s00784-020-03769-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/28/2020] [Indexed: 12/23/2022]
Abstract
Objectives The aims of this retrospective study were to report data on the prevalence of retrograde peri-implantitis (RPI) in a single-center in a 20-year observation period and to evaluate implant survival after surgical treatment. Materials and methods A retrospective cohort study was conducted screening all patients who underwent implant treatment in a private practice. Patients were enrolled if they had one or more implants showing a radiolucency around the implant apex, without implant mobility. Furthermore, clinical symptoms of RPI and days from symptoms’ appearance after implant placement were also collected, as well as periodontal and endodontic status of nearby teeth. All patients were treated with the same surgical approach: antibiotic therapy, mechanical curettage, chemical decontamination and xenograft application. Results Out of the 1749 implants placed, only 6 implants were classified as affected by RPI, with a prevalence of 0.34%. Clinical symptoms of RPI (pain, swelling, dull percussion or fistula presence) varied among patients and were reported after a mean period of 51.83 ± 52.43 days. Conclusions RPI was successfully treated with surgical curettage and bone substitute application and all implants are still in place after a mean follow-up of 8.83 ± 5.34 years. Clinical relevance Bacteria from teeth with failed endodontic treatment or residual lesions might be reactivated by drilling for implant osteotomy, with subsequent colonization of the implant apex and possible failure before prosthetic loading. Therefore, it might be recommended to take a periapical x-ray at implant placement and after 6–8 weeks in order to intercept RPI before prostheses delivery.
Collapse
Affiliation(s)
- Bianca Di Murro
- Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Via Caserta 6, 00161, Rome, Italy
| | | | - Giorgio Pompa
- Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Via Caserta 6, 00161, Rome, Italy
| | | | - Piero Papi
- Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Via Caserta 6, 00161, Rome, Italy.
| |
Collapse
|
|
22
|
Abd-Ul-Salam H. Peri-implantitis. INNOVATIVE PERSPECTIVES IN ORAL AND MAXILLOFACIAL SURGERY 2021:47-59. [DOI: 10.1007/978-3-030-75750-2_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
|
|
23
|
Rea M, Bengazi F, Velez JU, De Rossi EF, Mainetti T, Botticelli D. Implants placed into alveoli with periapical lesions: an experimental study in dogs. Oral Maxillofac Surg 2020; 25:351-357. [PMID: 33219872 DOI: 10.1007/s10006-020-00926-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To histologically analyze the effect of a curettage of the granulation tissue on healing at implants installed immediately after the extraction of teeth presenting periapical lesions. MATERIAL AND METHODS In seven dogs, the dental pulp was removed from the pulp chamber and from the root canals of the right and left third and the fourth mandibular premolars and of the left second premolar. The chambers were left opened and, after 3 months, apical lesions were present, and the premolars were extracted. One alveolus each premolar was selected and, before implant installation, the apical lesions of two alveoli were curetted (curettage group) while the other three were not treated (no-treatment group). The second right premolar was also extracted (Negative control group). Six implants each dog were installed, and a fully submerged healing was allowed. Four months after, biopsies were collected, and histological analyses were performed. RESULTS The proportions of new bone at the entire body of the implant was 70.2 ± 10.7% at the no-treatment group, 72.1 ± 14.8% at the curettage group, and 69.6 ± 3.7% at the negative control group. The respective new bone proportion at the apical aspect of the implants was 68.4 ± 17.5%, 61.5 ± 27.3%, and 78.1 ± 5.7%. None of the differences among the various groups were statistically significant. No inflammatory infiltrates were seen in the apical region. CONCLUSIONS In this experimental study, it is concluded that the removal of the granulation tissue seems not to be necessary to obtain a proper osseointegration of implants installed immediately after the extraction of teeth presenting a periapical lesion.
Collapse
Affiliation(s)
| | - Franco Bengazi
- Faculty of Dentistry, University of Medical Science, La Habana, Cuba
| | | | | | | | - Daniele Botticelli
- ARDEC Academy, Viale Giovanni Pascoli, 67, Rimini, Italy. .,Fundación ARDEC, Cartagena de Indias, Colombia.
| |
Collapse
|
|
24
|
Di Murro B, Pranno N, Raco A, Pistilli R, Pompa G, Papi P. Knowledge and Attitude towards Retrograde Peri-Implantitis among Italian Implantologists: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228356. [PMID: 33198070 PMCID: PMC7696335 DOI: 10.3390/ijerph17228356] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/06/2020] [Accepted: 11/10/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Retrograde peri-implantitis (RPI) is a pathological entity with an unclear etiology (e.g., overheating during implant insertion, residual infection of the tooth replaced by the implant or the endodontic lesion of neighboring teeth) and an extremely low prevalence and has been scarcely investigated. Therefore, the aim of this cross-sectional survey was to evaluate the knowledge and attitude of Italian implantologists regarding RPI. METHODS An anonymous questionnaire was sent via email to implantologists randomly selected, including a section about demographic information and questions related to RPI origin, radiographic representation, symptoms and treatment options. All questions were multiple answer and close-ended. Binomial logistic regression was performed to investigate the relationship between correct answers and the following independent variables: age, years of experience and number of dental implants placed per year. RESULTS In total, 475 implantologists completed the questionnaire, with a response rate of 46.3%. Based on the results of the study, incorrect answers were associated with less experienced participants (<80 implants/year) for all questions evaluated, with the exception of treatment strategies. Furthermore, 26.7% of the survey takers did not recognize radiographic representation of RPI and 35.5% picked "implant removal" when asked about treatment modality. CONCLUSIONS The majority of participants were able to recognize symptoms and indicated the probable causes of RPI; however, around 30% of them showed very limited knowledge of available management strategies.
Collapse
Affiliation(s)
- Bianca Di Murro
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (B.D.M.); (N.P.); (A.R.); (G.P.)
| | - Nicola Pranno
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (B.D.M.); (N.P.); (A.R.); (G.P.)
| | - Andrea Raco
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (B.D.M.); (N.P.); (A.R.); (G.P.)
| | - Roberto Pistilli
- Oral and Maxillofacial Unit, San Camillo Hospital, 00152 Rome, Italy;
| | - Giorgio Pompa
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (B.D.M.); (N.P.); (A.R.); (G.P.)
| | - Piero Papi
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (B.D.M.); (N.P.); (A.R.); (G.P.)
- Correspondence:
| |
Collapse
|
|
25
|
Di Murro B, Papi P, Di Murro C, Pompa G, Gambarini G. Correlation between endodontic pulpal/periapical disease and retrograde peri-implantitis: A case series. AUST ENDOD J 2020; 47:358-364. [PMID: 33159493 DOI: 10.1111/aej.12458] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/26/2020] [Accepted: 10/21/2020] [Indexed: 12/30/2022]
Abstract
Retrograde peri-implantitis is a symptomatic complication, characterised by radiographic detection of bone loss at the periapex of the implant. The aim of this study was to investigate the possible endodontic aetiology, evaluating the effectiveness of surgical treatment without endodontic therapy of adjacent teeth. In the 10-year interval, three patients reported symptoms of retrograde peri-implantitis after a mean period of 30.6 days from implant placement. Mean follow-up after surgical procedures was 8.66 years, with an implant survival of 100%. Retrograde peri-implantitis was probably caused by colonisation of the apical surface of the implant by bacteria persisting in the area after endodontic failure/apical periodontitis, reactivated by drilling in the site. In all cases, the adjacent teeth remained vital during the years, showing that a direct cause-and-effect relationship between pulpal/periapical disease of adjacent teeth and retrograde peri-implantitis was never present.
Collapse
Affiliation(s)
- Bianca Di Murro
- Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - Piero Papi
- Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | | | - Giorgio Pompa
- Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - Gianluca Gambarini
- Endodontic Unit, Department of Oral and Maxillofacial Sciences, 'Sapienza' University of Rome, Rome, Italy
| |
Collapse
|
|
26
|
Sisli SN, Pektas ZO. What Is the Role of Endodontic Predisposing Factors in Early Implant Failure? J ORAL IMPLANTOL 2020; 46:491-495. [PMID: 32315422 DOI: 10.1563/aaid-joi-d-19-00141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We aimed to investigate a possible relationship between early implant failure (EIF) and an adjacent root canal-treated tooth and/or tooth with a periapical lesion (PL), considering the duration between implantation and root canal treatment (RCT). The importance of prior RCT and/or presence of a PL before implantation was also investigated. A total of 810 implants from 342 patients were included and scored according to the implant failure before abutment connection, adjacent root canal treated teeth, adjacent teeth without RCT, no adjacent teeth, adjacent teeth with PL, extraction of teeth with PL, and/or RCT before implantation. The durations between the extraction and implantation and between RCT and implantation adjacent to the root canal-treated teeth were recorded. The time from the RCT of adjacent teeth to implant placement was categorized into 5 groups: less than 4 weeks before implantation, 4-12 weeks before implantation, at least 12 weeks before implantation, within 4 weeks after implantation, and at least 4 weeks after implantation. Among the endodontic predictors, a prior PL on the tooth extracted was associated with an increased risk of EIF (P < .05, odds ratio: 4.37; 95% confidence interval: 1.604-11.891). Furthermore, EIF was more likely to occur when the RCT of an adjacent tooth was performed within 4 weeks of implantation (P < .05). Additional investigations with larger sample sizes are necessary to validate our findings.
Collapse
Affiliation(s)
- Selen Nihal Sisli
- Baskent University Faculty of Dentistry, Department of Endodontics, Ankara, Turkey
| | - Zafer Ozgur Pektas
- Private Clinic, Department of Oral and Maxillofacial Surgery, Adana, Turkey
| |
Collapse
|
|
27
|
Hu KS, Li H, Tu YK, Lin SJ. Esthetic results of immediate implant placement in extraction sockets with intact versus deficient walls. J Dent Sci 2020; 16:108-114. [PMID: 33384786 PMCID: PMC7770323 DOI: 10.1016/j.jds.2020.06.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/20/2020] [Indexed: 12/02/2022] Open
Affiliation(s)
- Kang-Shuo Hu
- Department of Periodontology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Hua Li
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Shih-Jung Lin
- Department of Periodontology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,College of Dentistry, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
|
28
|
Fouda AAH. The impact of the alveolar bone sites on early implant failure: a systematic review with meta-analysis. J Korean Assoc Oral Maxillofac Surg 2020; 46:162-173. [PMID: 32606277 PMCID: PMC7338630 DOI: 10.5125/jkaoms.2020.46.3.162] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/25/2020] [Accepted: 04/01/2020] [Indexed: 12/28/2022] Open
Abstract
Dental implants are the first option for replacement of missing teeth. Failure usually involves additional cost and procedures. As a result, the physician should limit the risk factors associated with implant failures. Implant site is one of many factors that can influence the success or failure of dental implants. The association between early implant failure (EIF) and implant site has yet to be documented. This review aims to estimate the impact of insertion site on the percentage of EIFs. An electronic and manual search of studies that reported early failure of dental implants based on collection site. A total of 21 studies were included in the review and examined for the association between EIF and alveolar site. Subgroup analysis, including a comparison between implants inserted in four alveolar ridge regions of both jaws was performed. The early failure rate was higher for maxillary implants (3.14%) compared to mandibular implants (1.96%). Applying a random effect, risk ratio (RR), and confidence interval (CI) of 95% revealed higher failure in the maxilla compared to the mandible (RR 1.41; 95% CI [1.19, 1.67]; P<0.0001; I2=58%). The anterior maxilla is more critical for early implant loss than other alveolar bone sites. Implants in the anterior mandible exhibited the best success rate compared of the sites.
Collapse
|
|
29
|
Saleh MHA, Khurshid H, Travan S, Sinjab K, Bushahri A, Wang HL. Incidence of retrograde peri-implantitis in sites with previous apical surgeries: A retrospective study. J Periodontol 2020; 92:54-61. [PMID: 32452035 DOI: 10.1002/jper.20-0056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/21/2020] [Accepted: 03/26/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Retrograde peri-implantitis (RPI) is a rapidly progressing periapical infection that forms around the implant apex. It is usually associated with sites adjacent to teeth with apical lesions; previous endodontic failures, retained root fragments, etc. This study aimed to study the incidence of RPI in sites with a history of apical surgeries. METHODS Patients with sites treated for both apicoectomy and implant placement presenting to the University of Michigan School of Dentistry from 2001 to 2016 were screened. A total of 502 apicoectomies were performed, only 25 of these fit the predetermined eligibility criteria and were thus included in this retrospective analysis. RESULTS Implants that were placed in sites with a previous apical surgery had a cumulative survival rate of 92%. The incidence of peri-implantitis was 8%, while the incidence of RPI was 20%. There was an increased trend for RPI in cases where the cause of extraction was persistent apical periodontitis (35.7%), but this increase didn't reach the level of statistical significance (P = 0.061). CONCLUSION Implants placed in sites with previous apical surgery are not at an increased risk of implant failure or RPI.
Collapse
Affiliation(s)
- Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Periodontics, University of Louisville School of Dentistry, Louisville, KY, USA
| | - Hadiya Khurshid
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Suncica Travan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Khaled Sinjab
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Ali Bushahri
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| |
Collapse
|
|
30
|
Successive Reimplantation of Dental Implants Into Sites of Previous Failure. J Oral Maxillofac Surg 2020; 78:375-385. [DOI: 10.1016/j.joms.2019.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/04/2019] [Accepted: 10/04/2019] [Indexed: 12/30/2022]
|
|
31
|
Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Periodontol 2019; 89 Suppl 1:S267-S290. [PMID: 29926957 DOI: 10.1002/jper.16-0350] [Citation(s) in RCA: 430] [Impact Index Per Article: 71.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES This narrative review provides an evidence-based overview on peri-implantitis for the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. METHODS A literature review was conducted addressing the following topics: 1) definition of peri-implantitis; 2) conversion from peri-implant mucositis to peri-implantitis, 3) onset and pattern of disease progression, 4) characteristics of peri-implantitis, 5) risk factors/indicators for peri-implantitis, and 6) progressive crestal bone loss in the absence of soft tissue inflammation. CONCLUSIONS 1)Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. 2)The histopathologic and clinical conditions leading to the conversion from peri-implant mucositis to peri-implantitis are not completely understood. 3)The onset of peri-implantitis may occur early during follow-up and the disease progresses in a non-linear and accelerating pattern. 4a)Peri-implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements. 4b)At the histologic level, compared to periodontitis sites, peri-implantitis sites often have larger inflammatory lesions. 4c)Surgical entry at peri-implantitis sites often reveals a circumferential pattern of bone loss. 5a)There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying "smoking" and "diabetes" as potential risk factors/indicators for peri-implantitis are inconclusive. 5b)There is some limited evidence linking peri-implantitis to other factors such as: post-restorative presence of submucosal cement, lack of peri-implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance. 6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.
Collapse
Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, ZMK School of Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| |
Collapse
|
|
32
|
Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Clin Periodontol 2019; 45 Suppl 20:S246-S266. [PMID: 29926484 DOI: 10.1111/jcpe.12954] [Citation(s) in RCA: 450] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 01/14/2023]
Abstract
OBJECTIVES This narrative review provides an evidence-based overview on peri-implantitis for the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. METHODS A literature review was conducted addressing the following topics: 1) definition of peri-implantitis; 2) conversion from peri-implant mucositis to peri-implantitis, 3) onset and pattern of disease progression, 4) characteristics of peri-implantitis, 5) risk factors/indicators for peri-implantitis, and 6) progressive crestal bone loss in the absence of soft tissue inflammation. CONCLUSIONS 1)Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. 2)The histopathologic and clinical conditions leading to the conversion from peri-implant mucositis to peri-implantitis are not completely understood. 3)The onset of peri-implantitis may occur early during follow-up and the disease progresses in a non-linear and accelerating pattern. 4a)Peri-implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements. 4b)At the histologic level, compared to periodontitis sites, peri-implantitis sites often have larger inflammatory lesions. 4c)Surgical entry at peri-implantitis sites often reveals a circumferential pattern of bone loss. 5a)There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying "smoking" and "diabetes" as potential risk factors/indicators for peri-implantitis are inconclusive. 5b)There is some limited evidence linking peri-implantitis to other factors such as: post-restorative presence of submucosal cement, lack of peri-implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance. 6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.
Collapse
Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, ZMK School of Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| |
Collapse
|
|
33
|
Crippa R, Aiuto R, Guardincerri M, Peñarrocha Diago M, Angiero F. Effect of Laser Radiation on Infected Sites for the Immediate Placement of Dental Implants. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 38:186-192. [PMID: 31429669 DOI: 10.1089/photob.2019.4636] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: The study aims to evaluate the feasibility of erbium-chromium: yttrium-scandium-gallium-garnet (ErCr:YSGG 2780 nm) laser irradiation on infected and/or inflamed post-extraction sites for the immediate placement, and when possible, immediate loading, of endosseous implants. Background: Post-extraction site infection is a serious complication. Surgical and nonsurgical options are available to treat such event, together with various decontamination methods. However, there is still no consensus on which treatment is the most effective. Materials and methods: Sixty-six patients were included in the study for a total of 94 post-extraction implants, inserted in the maxilla and mandible. All patients were eligible for implant therapy, having at least one compromised tooth requiring extraction, along with sign of inflammation and/or infection. Surgery and socket decontamination were performed using an ErCr:YSGG laser. To improve bone healing, Bio-Oss® and resorbable membrane were used in 57 patients. Eleven implants were immediately loaded, whereas 83 were loaded within 3-6 months, depending on the extraction site. Intraoral radiographs were taken at 1, 3, 6, 9, and 12 months from the implant placement to assess the alveolar bone level and treatment's outcome. Albrektsson criteria were chosen to evaluate the treatment success rate. Results: Follow-up went from 6 months to 4 years. Success rate was 94.6% (89/94): three implants failed to integrate due to poor patient compliance, being expelled during the second week, whereas two implants presented factory defects (abutment). No sockets presented signs of residual infection during follow-up. Conclusions: The combination of mechanical, chemical, and laser treatment was proven to be highly effective for the disinfection of post-extraction sites. The ErCr:YSGG laser is a useful tool, not only for his practicality as a surgical device but also as a disinfection tool, granting optimal results after implant surgery.
Collapse
Affiliation(s)
- Rolando Crippa
- Department of Oral Pathology, Italian Stomatological Institute, Milan, Italy
| | - Riccardo Aiuto
- Department of Oral Surgery, University of Valencia, València, Spain
| | - Marco Guardincerri
- Department of Medical Sciences and Diagnostic Integrated, S. Martino Hospital, University of Genoa, Genova, Italy
| | | | - Francesca Angiero
- Department of Medical Sciences and Diagnostic Integrated, S. Martino Hospital, University of Genoa, Genova, Italy
| |
Collapse
|
|
34
|
Wang H, Wang J, Guo T, Ding X, Yu W, Zhao J, Zhou Y. The endoscopically assisted transcrestal sinus floor elevation with platelet-rich fibrin at an immediate implantation of periapical lesion site: A case report. Medicine (Baltimore) 2019; 98:e16251. [PMID: 31277143 PMCID: PMC6635277 DOI: 10.1097/md.0000000000016251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE The traditional maxillary sinus floor elevation has serious postoperative complications and long healing periods, for patients with insufficient residual bone height (RBH). The endoscopic technique improves the blind nature of the sinus floor elevation procedure. Platelet-rich fibrin (PRF) can promote tissue healing and prevent perforation. PATIENT CONCERN A 25-year-old female with residual roots in the maxillary right second molar visited our hospital for dental implants. DIAGNOSE CBCT results showed a low-density shadow at the root tip, and the height of the periapical distance from the maxillary sinus floor was less than 1 mm. INTERVENTION Patient was immediately subjected to implant after root extraction. Two-step sinus floor elevation was performed under endoscopy. A 12 mm-long implant was installed. OUTCOMES At 10 months after surgery, the hard and soft tissues were stable, and a full-ceramic crown was placed. LESSONS Immediate implant and endoscope-guided sinus floor elevation through a transcrestal approach by using PRF as the only grafting material is viable in periapical infected sites with a RBH of less than 1 mm.
Collapse
|
|
35
|
Nonsurgical Endodontic Treatment of Necrotic Teeth Resolved Apical Lesions on Adjacent Implants with Retrograde/Apical Peri-implantitis: A Case Series with 2-year Follow-up. J Endod 2019; 45:645-650. [DOI: 10.1016/j.joen.2019.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/18/2018] [Accepted: 01/03/2019] [Indexed: 11/21/2022]
|
|
36
|
Khouly I, Braun RS, Chambrone L. Antibiotic prophylaxis may not be indicated for prevention of dental implant infections in healthy patients. A systematic review and meta-analysis. Clin Oral Investig 2019; 23:1525-1553. [DOI: 10.1007/s00784-018-2762-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/17/2018] [Indexed: 01/23/2023]
|
|
37
|
Temmerman A, Rasmusson L, Kübler A, Thor A, Merheb J, Quirynen M. A Prospective, Controlled, Multicenter Study to Evaluate the Clinical Outcome of Implant Treatment in Women with Osteoporosis/Osteopenia: 5-Year Results. J Dent Res 2018; 98:84-90. [PMID: 30205020 DOI: 10.1177/0022034518798804] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The impact of osteoporosis on implant treatment is still a matter of debate in the scientific community, as it may possibly lead to higher failure rates. As long-term controlled trials are missing, the aim of this study was to verify the long-term outcome of implants placed in patients with systemic osteoporosis. Postmenopausal women in need of implants underwent bone mineral density measurements in hip and spine, using dual X-ray absorptiometry scans. Based on T-scores, they were divided into 2 groups: group O (osteoporosis group) with a T-score ≤-2 or group C (control group) with a T-score of ≥-1. Implants were placed in a 2-stage manner and loaded 4 to 8 wk after abutment surgery. Six months after loading and thereafter yearly, clinical and radiographical parameters were assessed. In total, 148 implants were placed in 48 patients (mean age: 67 y [range, 59-83]). Sixty-three implants were placed in 20 patients (group O) and 85 implants in 28 patients (group C). After 5 y, 117 implants (38 in group O and 79 in the group C) in 37 patients were assessed. Cumulative survival rate on an implant level was 96.5% (group O: 91.5%; group C: 100.0% [ P < 0.05]) and 95.7% (group O: 89.2%; group C: 100.0% [ P > 0.05]) on a patient level. The overall marginal bone-level alterations, after 5 y of loading, were -0.09 ± 0.78 mm (group O: -0.15 ± 0.50 mm; group C: -0.06 ± 0.89 mm) on an implant level and -0.09 ± 0.54 mm (group O: -0.18 ± 0.43 mm; group C: 0.06 ± 0.58 mm) on a patient level ( P > 0.05). Oral implant therapy in osteoporotic patients is a reliable treatment option with comparable osseointegration rates, implant survival, and marginal bone-level alterations after 5 y of functional loading (ClinicalTrials.gov NCT00745121).
Collapse
Affiliation(s)
- A Temmerman
- 1 Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - L Rasmusson
- 2 Department of Oral and Maxillofacial Surgery, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Kübler
- 3 Department of Oral and Maxillofacial Plastic Surgery, University of Würzburg, Würzburg, Germany
| | - A Thor
- 4 Department of Oral and Maxillofacial Surgery, Institute of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - J Merheb
- 1 Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - M Quirynen
- 1 Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| |
Collapse
|
|
38
|
Lee J, Park D, Koo KT, Seol YJ, Lee YM. Comparison of immediate implant placement in infected and non-infected extraction sockets: a systematic review and meta-analysis. Acta Odontol Scand 2018; 76:338-345. [PMID: 29611763 DOI: 10.1080/00016357.2018.1453084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE This review aimed to investigate the feasibility of immediate implant placement in infected extraction sockets. MATERIAL AND METHODS We performed electronic and manual searches up to March 2017 to obtain data from randomized controlled trials (RCTs) and nonrandomized controlled clinical trials (CCTs). Using a fixed-effects model to assess the difference in survival rate (primary outcome), we evaluated the risk difference for immediate implant placement in infected and non-infected sites. We estimated the weighted mean differences (WMDs) of the change in marginal bone loss (MBL), probing depth (PD), modified bleeding index (mBI), marginal gingival level (MGL) and width of keratinized gingiva (WKG) at baseline and latest follow-up. RESULTS In total, five studies (0 RCT, five CCTs) were included in the systematic review and three studies were included in the meta-analysis. The risk difference for immediate implant placement in an infected extraction socket compared with that in a non-infected socket was -0.02. WMDs for MBL, PD, mBI, MGL and WKG between the two groups were 0.32, 0.12, 0.07, -0.06, 0.20 and 0.51, respectively. No statistical differences were observed between the two groups, except for the change in WKG. CONCLUSIONS Implants can be placed in infected extraction sockets after thorough socket debridement. For aesthetics, WKG should be considered when performing immediate implant placement in infected sites.
Collapse
Affiliation(s)
- Jungwon Lee
- Department of Periodontology and Dental Research Institute, Seoul National University, School of Dentistry, Seoul, Republic of Korea
| | - Dueun Park
- Department of Periodontology and Dental Research Institute, Seoul National University, School of Dentistry, Seoul, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, Seoul National University, School of Dentistry, Seoul, Republic of Korea
| | - Yang-Jo Seol
- Department of Periodontology and Dental Research Institute, Seoul National University, School of Dentistry, Seoul, Republic of Korea
| | - Yong-Moo Lee
- Department of Periodontology and Dental Research Institute, Seoul National University, School of Dentistry, Seoul, Republic of Korea
| |
Collapse
|
|
39
|
Immediate Early and Delayed Implants: A 2-Year Prospective Cohort Study of 131 Transmucosal Flapless Implants Placed in Sites With Different Pre-extractive Endodontic Infections. IMPLANT DENT 2018; 26:654-663. [PMID: 28945667 DOI: 10.1097/id.0000000000000666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION To evaluate clinical outcome of early, immediate, and delayed transmucosal implants placed in patients affected by acute/chronic endodontic lesions. MATERIALS AND METHODS Eighty-five consecutive patients received 131 titanium implants with zirconium-oxide blasted surface. Pre-extractive diagnosis represented the main criteria for implant placement timing, following "best treatment" criteria. Implants were placed with flapless transmucosal technique. Hopeless teeth with chronic periapical lesions received atraumatic extraction, and an implant was immediately placed (Immediate Group, n = 29). Teeth with acute periapical lesion/abscess were extracted and implants placed after 8 to 12 weeks (Early Group, n = 29). Implants placed 10- to 12-month after extraction constituted the control group (delayed group, n = 73). Implants were loaded 3 months after insertion with provisional resin crowns and after approximately 15 days with definitive ceramic crowns. Marginal bone loss (MBL) was measured in a single-blind manner on periapical radiographs at 1, 3, 6, 12, and 24 months. RESULTS Multilevel analysis described exploring factors associated with MBL. Survival rate was 100%. MBL after 24 months was 0.78 ± 0.70 (95% confidence interval [CI]: 0.20 to -1.37) at immediate, 0.48 ± 0.70 at early (95% CI: -0.006 to -0.961), and 1.02 ± 1.01 (95% CI: 0.61 to -1.43) at delayed groups. Implant groups (immediate/early/delayed) and location (maxillary/mandibular) showed statistically significant results. Early group showed the lowest MBL values. The immediate group demonstrated less MBL than the delayed group. CONCLUSION Early implant placement technique preserves periimplant marginal bone level more than immediate and delayed techniques.
Collapse
|
|
40
|
Management of Retrograde Peri-Implantitis Using an Air-Abrasive Device, Er,Cr:YSGG Laser, and Guided Bone Regeneration. Case Rep Dent 2018; 2018:7283240. [PMID: 29850281 PMCID: PMC5925184 DOI: 10.1155/2018/7283240] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 03/19/2018] [Indexed: 12/30/2022] Open
Abstract
Background The placement of an implant in a previously infected site is an important etiologic factor contributing to implant failure. The aim of this case report is to present the management of retrograde peri-implantitis (RPI) in a first maxillary molar site, 2 years after the implant placement. The RPI was treated using an air-abrasive device, Er,Cr:YSGG laser, and guided bone regeneration (GBR). Case Description A 65-year-old Caucasian male presented with a draining fistula associated with an implant at tooth #3. Tooth #3 revealed periapical radiolucency two years before the implant placement. Tooth #3 was extracted, and a ridge preservation procedure was performed followed by implant rehabilitation. A periapical radiograph (PA) showed lack of bone density around the implant apex. The site was decontaminated with an air-abrasive device and Er,Cr:YSGG laser, and GBR was performed. The patient was seen every two weeks until suture removal, followed by monthly visits for 12 months. The periapical X-rays, from 6 to 13 months postoperatively, showed increased bone density around the implant apex, with no signs of residual clinical or radiographic pathology and probing depths ≤4 mm. Conclusions The etiology of RPI in this case was the placement of an implant in a previously infected site. The use of an air-abrasive device, Er,Cr:YSGG, and GBR was utilized to treat this case of RPI. The site was monitored for 13 months, and increased radiographic bone density was noted.
Collapse
|
|
41
|
Chatzopoulos GS, Wolff LF. Implant failure and history of failed endodontic treatment: A retrospective case-control study. J Clin Exp Dent 2017; 9:e1322-e1328. [PMID: 29302285 PMCID: PMC5741846 DOI: 10.4317/jced.54277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/09/2017] [Indexed: 11/29/2022] Open
Abstract
Background Residual bacterial biofilm and/or bacteria in planktonic form may be survived in the bone following an extraction of an infected tooth that was endodontically treated unsuccessfully Failed endodontic treatment may be associated with failure of implants to osseointegrate in the same sites. Therefore, the aim of this retrospective case-control study is to examine the risk of implant failure in previous failed endodontic sites. Material and Methods This retrospective case-control study is based on 94 dental records of implants placed at the University of Minnesota School of Dentistry. Dental records of patients who received an implant in sites with previously failed endodontic therapy in the dental school were identified from the electronic database, while control subjects were obtained from the same pool of patients with the requirement to have received an implant in a site that was not endodontically treated. Results The mean age of the population was 62.89±14.17 years with 57.4% of the sample being females and 42.6% of them being males. In regards to the socio-economic status and dental insurance, 84.0% of this population was classified as low socio-economic status and 68.1% had dental insurance. Tobacco use was self-reported by 9.6% and hypercholesterolemia was the most prevalent systemic medical condition. Dental implant failure was identified in two of the included records (2.1%), both of which were placed in sites with a history of failed endodontic treatment. Conclusions Within the limitations of this retrospective case-control study, further investigation with a larger population group into implant failure of sites that previously had unsuccessful endodontic treatment would be warranted. Implant failure may be associated with a history of failed endodontic treatment. Key words:Implantology, endodontics, osseointegration, treatment outcome, case-control study.
Collapse
Affiliation(s)
- Georgios S Chatzopoulos
- DDS, Advanced Education Program in Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, 515 Delaware St. SE, Minneapolis, MN 55455
| | - Larry F Wolff
- MS, PhD, DDS, Professor, Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, 515 Delaware St. SE, Minneapolis, MN 55455
| |
Collapse
|
|
42
|
Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. Survival of dental implants placed in sites of previously failed implants. Clin Oral Implants Res 2017; 28:1348-1353. [PMID: 27743398 DOI: 10.1111/clr.12992] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the survival of dental implants placed in sites of previously failed implants and to explore the possible factors that might affect the outcome of this reimplantation procedure. MATERIALS AND METHODS Patients that had failed dental implants, which were replaced with the same implant type at the same site, were included. Descriptive statistics were used to describe the patients and implants; survival analysis was also performed. The effect of systemic, environmental, and local factors on the survival of the reoperated implants was evaluated. RESULTS 175 of 10,096 implants in 98 patients were replaced by another implant at the same location (159, 14, and 2 implants at second, third, and fourth surgeries, respectively). Newly replaced implants were generally of similar diameter but of shorter length compared to the previously placed fixtures. A statistically significant greater percentage of lost implants were placed in sites with low bone quantity. There was a statistically significant difference (P = 0.032) in the survival rates between implants that were inserted for the first time (94%) and implants that replaced the ones lost (73%). There was a statistically higher failure rate of the reoperated implants for patients taking antidepressants and antithrombotic agents. CONCLUSIONS Dental implants replacing failed implants had lower survival rates than the rates reported for the previous attempts of implant placement. It is suggested that a site-specific negative effect may possibly be associated with this phenomenon, as well as the intake of antidepressants and antithrombotic agents.
Collapse
Affiliation(s)
- Bruno R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Jenö Kisch
- Clinic for Prosthodontics, Centre of Dental Specialist Care, Malmö, Sweden
| | - Tomas Albrektsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Biomaterials, Göteborg University, Göteborg, Sweden
| | - Ann Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| |
Collapse
|
|
43
|
Blaya-Tárraga JA, Cervera-Ballester J, Peñarrocha-Oltra D, Peñarrocha-Diago M. Periapical implant lesion: A systematic review. Med Oral Patol Oral Cir Bucal 2017; 22:e737-e749. [PMID: 29053646 PMCID: PMC5813993 DOI: 10.4317/medoral.21698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 05/26/2017] [Indexed: 11/11/2022] Open
Abstract
Background The aim of this study was to systematically review the evidence for periapical implant lesion, which makes a patient more susceptible to the periapical lesion, frequency, symptoms, signs (including radiological findings) and possible treatment options. Material and Methods A systematic literature review and analysis of publications included in PubMed, Embase and Cochrane; articles published until March 2016; with a populations, exposures and outcomes (PEO) search strategy was performed, focused on the issue: “In patients with periapical lesion to the implant during the osseointegration, what symptoms, signs, and changes in complementary examination manifested, for according to that stage, be intervened with the appropriate approach?”. The set criteria for inclusion were peer-reviewed articles. Results From a total of 212 papers identified, 36 studies were included in this systematic review, with 15461 implants evaluated and 183 periapical implant lesions. Which 8 papers included more than 5 cases and 28 included equal or less than 5 cases. Analysis of the papers revealed that periapical implant lesion is classified according to evolution stages into acute (non-suppurated and suppurated) and subacute (or suppurated-fistulized). In the acute stage and in the subacute if there is no loss of implant stability, the correct treatment approach is implant periapical surgery. In the subacute stage associated with implant mobility the implant must be removed. Conclusions Evidence on the subject is very limited, there are few studies with small sample, without homogeneity of criteria for diagnosing the disease and without design of scientific evidence. Currently etiology lacks consensus. The early diagnosis of periapical implant periapical lesions during the osseointegration phase and early treatment, will lead to a higher survival rate of implants treated, hence preventing the need for implant extraction. Key words:Apical peri-implantitis, retrograde peri-implantitis, inflammatory peri-implantitis lesion.
Collapse
Affiliation(s)
- J-A Blaya-Tárraga
- Unidad de Cirugía Bucal, Facultat de Medicina i Odontologìa, Universitat de València, C/ Gascó Oliag 1, 46010 Valencia, Spain,
| | | | | | | |
Collapse
|
|
44
|
Sarmast ND, Wang HH, Sajadi AS, Angelov N, Dorn SO. Classification and Clinical Management of Retrograde Peri-implantitis Associated with Apical Periodontitis: A Proposed Classification System and Case Report. J Endod 2017; 43:1921-1924. [DOI: 10.1016/j.joen.2017.06.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/21/2017] [Accepted: 06/25/2017] [Indexed: 02/09/2023]
|
|
45
|
Zuffetti F, Capelli M, Galli F, Del Fabbro M, Testori T. Post-extraction implant placement into infected versus non-infected sites: A multicenter retrospective clinical study. Clin Implant Dent Relat Res 2017; 19:833-840. [DOI: 10.1111/cid.12523] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 01/09/2017] [Accepted: 07/07/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Francesco Zuffetti
- Section of Implant Dentistry and Oral Rehabilitation; Dental Clinic, IRCCS Galeazzi Institute; Milan Italy
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
| | - Matteo Capelli
- Section of Implant Dentistry and Oral Rehabilitation; Dental Clinic, IRCCS Galeazzi Institute; Milan Italy
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
| | - Fabio Galli
- Section of Implant Dentistry and Oral Rehabilitation; Dental Clinic, IRCCS Galeazzi Institute; Milan Italy
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- Section of Oral Physiology; IRCCS Galeazzi Institute; Milan Italy
| | - Tiziano Testori
- Section of Implant Dentistry and Oral Rehabilitation; Dental Clinic, IRCCS Galeazzi Institute; Milan Italy
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
| |
Collapse
|
|
46
|
Rodriguez LC, Saba JN, Chung KH, Wadhwani C, Rodrigues DC. In vitro effects of dental cements on hard and soft tissues associated with dental implants. J Prosthet Dent 2017; 118:31-35. [DOI: 10.1016/j.prosdent.2016.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 10/01/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
|
|
47
|
Peñarrocha-Diago M, Peñarrocha-Diago M, Blaya-Tárraga JA. State of the art and clinical recommendations in periapical implant lesions. 9th Mozo-Grau Ticare Conference in Quintanilla, Spain. J Clin Exp Dent 2017; 9:e471-e473. [PMID: 28298994 PMCID: PMC5347301 DOI: 10.4317/jced.53600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 11/27/2016] [Indexed: 11/17/2022] Open
Abstract
This manuscript summarizes the statements and clinical recommendations in periapical implant lesions, as per the state of the art and expert opinion agreement among the participants in the 9th Mozo-Grau Conference 2016 held in Quintanilla (Valladolid, Spain). The current status of the concept, frequency, etiology, diagnosis, clinical classification, surgical procedure and prognosis are described. If following implant placement localized pain develops in the periapical area, with or without radiographic changes, the diagnosis of periapical implant lesion should be suspected. It is important to monitor the condition in order to identify any change in its evolution. Radiological changes in the periapical radiographs are not always manifest in the early stages, and in this regard small-volume cone beam computed tomography can help us visualize such peri-implant changes. The early diagnosis of periapical implant lesions during the osseointegration phase and the provision of early treatment result in increased implant survival rates, thereby avoiding the need for implant extraction.
Key words:Apical peri-implantitis, retrograde peri-implantitis, inflammatory peri-implantitis lesion.
Collapse
Affiliation(s)
- Miguel Peñarrocha-Diago
- MD, MDM, PhD, Professor and Chairman of Oral Surgery, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - María Peñarrocha-Diago
- MD, DMD, PhD, Assistant Professor of Oral Surgery, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - Juan-Antonio Blaya-Tárraga
- DDS, MSc. Master in Oral Surgery and Implantology. Faculty of Medicine and Dentistry, University of Valencia, Spain
| |
Collapse
|
|
48
|
Sarmast ND, Wang HH, Soldatos NK, Angelov N, Dorn S, Yukna R, Iacono VJ. A Novel Treatment Decision Tree and Literature Review of Retrograde Peri-Implantitis. J Periodontol 2016; 87:1458-1467. [DOI: 10.1902/jop.2016.160219] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
|
49
|
|
|
50
|
Abstract
PURPOSE To discuss the terminology, etiopathogenesis, and treatment of radiolucent inflammatory implant periapical lesions. MATERIALS AND METHODS An electronic search for relevant articles published in the English literature in the PubMed database. RESULTS Bacterial contamination of the apical portion of the implant either from a preexisting dental periapical infection or from a periapical lesion of endodontic origin of an adjacent tooth is the probable causative factor. Aseptic bone necrosis owing to overheating of the bone during preparation of osteotomies, or compression of the bone at the apex of the implant owing to excessive tightening, may also play a role. The histopathological features are of a mixed inflammatory cell infiltrate on a background of granulation tissue consistent with either a granuloma or an abscess as may be found at the apex of a nonvital tooth. Treatment consists of immediate and aggressive surgical debridement, chemical detoxification of the apical portion of the exposed implant surface, and systemic antibiotics with or without a bone regenerative procedure. CONCLUSION A radiolucent inflammatory implant periapical lesion is analogous to either a granuloma or an abscess as may be found at the apex of a nonvital tooth.
Collapse
|